Readers and Tweeters Chime In on Incapacity Rights and Drug Reductions


Letters to the Editor is a periodic characteristic. We welcome all feedback and can publish a variety. We edit for size and readability and require full names.

Coming Full Circle on Protections for These With Disabilities

As a retired particular training instructor, I’m questioning why our aged in retirement properties aren’t lined by the American with Disabilities Act (“‘Impending Intergenerational Disaster’: Individuals With Disabilities Lack Lengthy-Time period Care Plans,” Dec. 11). The act covers all the problems confronted by our aged in retirement properties as for youngsters with these similar wants. College students get a yearly prescription plan by way of a gathering with their mother and father, all who are available in contact with them to supply companies, and an administrator. Why isn’t this yearly plan in place for our aged in retirement or nursing properties? Youngsters go from newborns to toddlers, and on up by way of the expansion and maturity ladder. Our aged undergo these similar levels however in reverse. The care we give the aged ought to mirror the care given to kids albeit for, maybe, an extended time in every stage. This could necessitate some main modifications to current federal, state, and native laws. I get that every one however essentially the most devoted and concerned would battle this concept and take into account our older inhabitants as throwaways. As Florida Gov. Ron DeSantis mentioned, “Allow them to die.” Thanks for permitting this chance to throw in my two cents.

— Judy Galt, Orange Park, Florida

I hadn’t given this a lot thought however I do see it. Child-boomer era will go and disabled offspring might extra usually lack enough plans: “Impending Intergenerational Disaster’: Individuals With Disabilities Lack Lengthy-Time period Care Plans” | Kaiser Well being Information

— Carl Hindy, Ph.D., Scientific Psychologist (@DrCarlHindy) November 11, 2022

— Carl Hindy, Exeter, New Hampshire

Revoking the Incapacity Tax

Thanks a lot for highlighting the issue blind people have with medical payments (“The Incapacity Tax: Medical Payments Stay Inaccessible for Many Blind Individuals,” Dec. 2). I nearly by no means see something associated to blindness and accessibility undergo my information feed, so although your findings are miserable, it made my day to know this difficulty was being highlighted within the nationwide information!

— Brandon Keith Biggs, Atlanta

Not stunned. I’m #deaf & medical suppliers nonetheless anticipate me to have the ability to hear & perceive essential information over the cellphone. The Individuals With Disabilities Act has no enamel. #blind #ada #kaiser #hhs #California #Indiana #aetna #anthem #MedTwitter #hoh

— Jim Hankins (@ltecato) December 2, 2022

— Jim Hankins, Anaheim, California

I need to personally thanks for reporting on this difficulty. There are workarounds for many people to get round them. Sadly, it’s a separate however equal predicament. And this isn’t simply with the medical system. Individuals who’re blind, who make the most of expertise, usually depend on paid subscription companies for finishing visible duties. One among them known as Aira. Educated folks information blind folks by way of numerous duties like navigating and filling out types on inaccessible web sites or take photos of payments and skim it to them.

The separate-but-equal standing is available in as a result of the overall inhabitants is unaware the blind are unemployed or underemployed. The employment charge for the blind is below 20% lower than convicted felons. The underemployment charge is 78%, partly due to outdated subminimum wage legal guidelines below Part 14(c) of the federal Truthful Labor Requirements Act that permits disabled folks in America to be paid beneath federal minimal wage by all the main firms, and all the things in between.

Once more, thanks for reporting on info that most individuals and the media received’t as a result of they aren’t the fluffy, fuzzy, feel-good points like blind folks ending faculty or doing one thing most individuals with imaginative and prescient merely do daily.

— William F. O’Donnell, Austin, Texas

Good article on how plan sponsors seize producers’ copay assist & affected person help funds for themselves (as a substitute of for sufferers)Not information to Drug Channels readers, however nonetheless good to see mainstream press protection@Julie_appleby @KHNews

— Adam J. Fein (@DrugChannels) December 11, 2022

— Adam J. Fein, Philadelphia

A Profit for Massive Pharma

Who earnings from affected person help and copay help packages? It ought to come as no shock that the wolves in sheep’s garments are, certainly, the pharmaceutical firms (“Employers Use Affected person Help Applications to Offset Their Personal Prices,” Dec. 6).

One level unnoticed of KHN’s article on these schemes, which symbolize a large return on funding for Massive Pharma: A pharmaceutical producer will cowl the prices of a affected person’s copay, typically even pay your entire deductible, to maintain the affected person on its dearer product (as a substitute of cheaper options the affected person’s well being plan would pay for). As soon as the deductible is met, the affected person’s employer is compelled to pay 80% or extra of the affected person’s drug prices. And, as soon as the affected person reaches their annual most out-of-pocket (MOOP) threshold, their employer begins paying 100% of the prices — and the drug firm returns to creating 100% revenue, and now not paying any help.

Oftentimes this implies the pharma firm primarily waives the prices of 1 or two doses of the drug, and the employer is then compelled to pay many instances that to cowl the drug for the remainder of the yr.

Pharmaceutical producers say the help packages are proof of their dedication to sustaining the affordability of pharmaceuticals, however in response to a latest report by the Congressional Analysis Service, “Prescription Drug Low cost Coupons and Affected person Help Applications (PAPs),” whereas a drug low cost coupon might cut back the quantity an insured client should pay out-of-pocket for a drug, it typically doesn’t cut back the worth charged to an insurer or authorities program for the drug. Which means sufferers pays increased premiums later.

The just lately revealed “Drug Producers’ Billion-Greenback Scheme,” by the Regence Well being Coverage Middle, requested this intriguing query: Are copay coupons “the answer for the unreasonable value of specialty medicines or a fastidiously crafted malicious program disrupting affordability in our well being care system?”

If pharmaceutical producers actually need to help sufferers, they need to cease the tips and schemes, and cost cheap drug costs within the U.S., as they do in each different developed nation.

— James Gelfand, president of The ERISA Business Committee, Washington, D.C.

If firms, together with insurers, channeled their creativity into making care higher and extra reasonably priced for sufferers, what a beautiful world it could be. Remark for those who agree.

— David Johnson (@4sighthealth_) December 14, 2022

— David Johnson, Chicago

Neighborhood Well being Facilities Are Clear, Trusted, and Important

In what seems to be a sample, the KHN article by Phil Galewitz and Bram Sable-Smith about group well being facilities (“When Malpractice Happens at Neighborhood Well being Facilities, Taxpayers Pay,” Nov. 28) makes use of selective knowledge and outlier instances to color a grossly inaccurate image of the life-sustaining care that group well being facilities present to 30 million Individuals.

Opposite to the distorted conclusions drawn by the article’s give attention to only a few proceedings, well being facilities present high-quality take care of tens of thousands and thousands of underserved and susceptible sufferers within the U.S.

Given the crucial function well being facilities play in well being care supply and the substantial improve within the variety of well being facilities and sufferers, malpractice claims are an unlucky actuality. KHN’s narrative focuses on a number of cherry-picked instances even because it acknowledges that “settlements and court docket judgments don’t measure the clinics’ total efficiency.” The article’s give attention to claims payouts throughout 2018 and 2021, although tragic, represents a tiny fraction of 117 million sufferers served and 477 million visits — which means the reporters targeted on far lower than 1 % of sufferers.

The bigger and unassailable story is that well being facilities implement rigorous safeguards to make sure one of the best affected person care. Federal Tort Claims Act protection — the federal protection that’s the focus of this text — just isn’t routinely granted to well being middle grantees. Somewhat, well being facilities should implement strong high quality enchancment and danger administration packages to qualify for and keep FTCA protection. Such protection permits important well being care companies to stay reasonably priced and accessible to economically challenged sufferers when and the place they want it. Moreover, well being facilities are topic to on-site auditing of those processes to make sure they meet acceptable requirements and performance as meant. FTCA protection makes well being facilities much more vigilant on high quality of care — not much less.

Each greenback invested in well being facilities returns worth to American taxpayers. This system generates annual system-wide financial savings of $24 billion yearly as a result of fewer well being middle sufferers require emergency room visits and hospitalizations. Extra essential than {dollars} saved, well being facilities are clear, trusted, and important stewards of public well being. We stand by their lengthy and profitable observe report.

— Rachel Gonzales-Hanson, interim CEO and president of the Nationwide Affiliation of Neighborhood Well being Facilities, Bethesda, Maryland

and one other latest story about malpractice at group well being facilities

— Taylor Emrey Glascock (@tayloremrey) November 30, 2022

— Taylor Emrey Glascock, Chicago

STD Testing: Don’t Attempt This at Dwelling?

Although dwelling testing for sexually transmitted infections could be worthwhile, maximizing the testing expertise we’ve got now could be much more worthwhile (“A New Use for Courting Apps: Chasing STDs,” Nov. 30). Sixty % of all STIs in high-risk individuals can’t be recognized through a urine pattern as a result of they’re extragenital (within the throat or rectum). STI testing ought to embody screening urine in addition to throat and rectum swabs for many individuals. This may very well be completed by labs giving purchasers swabs to self-collect, nevertheless Hologic (the corporate that produces the Aptima system pictured in your article) has not completed the validation research to permit its system for use on self-collected extragenital assessments. Thus, a affected person should go to a supplier to get the swabs collected, reasonably than simply go to the lab straight after orders are submitted. This isn’t a difficulty of latest expertise; this is a matter of guaranteeing we’re utilizing what we’ve got to its full capability, guaranteeing enough extragenital screening, and guaranteeing it may be completed in essentially the most handy manner potential. Molecular screens enable for home-based testing (collected at dwelling and despatched again to be processed). Halogen assessments, the system utilized by Quest, Labcorp, CPL, and so forth., don’t. Although having home-based fast outcomes could be nice (which, after all, would require self-collected samples), guaranteeing we’re in a position to maximize the expertise we’ve got out there now could be an enormous step ahead.

— Christine Brennan, New Orleans

Using apps might have exploded since, however we had been doing this 20 years in the past after I was an #EIS officer @CDCgov. Actually I needed to get entry to sure blocked web sites – it was attention-grabbing explaining that to the IT of us.

— Michael Greenberg MD (@greenbergepi) December 4, 2022

— Dr. Michael Greenberg, Bethlehem, Pennsylvania


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